Adoption Application - CCAR
Animal you are interested in adopting
Abu (Cat - U2024013)
Artemis (Cat - N2024011)
Astrid (Cat - S2024081)
Baron Sammie (Cat - S2024029)
Betty (Dog - A2024025)
Bo Peep (Cat - S2024058)
Carolina (Cat - N2024003)
Cayenne (Cat - N2024004)
Cleopatra (Cat - U2024087)
Cloud (Cat - N2024012)
Curtis (Dog - D2024001)
Deliyah (Cat - S2024082)
Fluffernutter (Cat - S2024073)
Fred Astaire (Cat - U2024115)
Fuji (Cat - S2024062)
George (Cat - U2024112)
Gladys (Cat - S2025010)
Harold (Cat - U2024111)
Heart (Cat - S2025006)
Henry (Dog - A2023001)
Jack Frost (Cat - S2024027)
Kaos (Cat - S2024046)
Lydia (Cat - S2024083)
Mama Dolly (Cat - N2024006)
Marilyn (Cat - S2025011)
Misty (Cat - N2024008)
Mrs. Grey (Mr) (Cat - S2024074)
Nala (Cat - S2025003)
Noel (Cat - S2024026)
Onyx (Dog - A2024015)
Puss in Boots (Cat - N2024009)
Red (Cat - S2025004)
Romeo (Cat - S2025005)
Sylvester (Cat - S2025012)
Thelma (Cat - S2025009)
Valentine (Cat - S2025007)
Walter (Cat - S2025008)
Animal you are interested in if not listed above:
Have you already met this animal? If so, where?
Applicant's First Name
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Applicant's Last Name
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Street Address
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City
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State
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Apartment Number (if applicable)
Zip Code
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Email Address
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Please enter correctly as this is the main way we will contact you
Primary Phone Number
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Date of Birth
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Is this pet for you or someone else?
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Myself
Someone else
Do you own other pets at the current time?
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No
Yes
If yes, please list their names, breeds, and ages.
Are all of your pets spayed/neutered/fixed?
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No
Yes
How many pets have you owned in the last 5-10 years?
What happened to them?
Are your pets current on their vaccinations?
Yes
no
n/a
Have you ever turned your dog or cat into a shelter?
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No
Yes
If yes, please explain?
Veterinarian's Name
If you have never owned a pet please tell us where you would go.
Veterinarian's Address, City, State, and Zip Code
Again if you have never owned a pet please list where you would go
Veterinarian's Phone Number
Have you ever had a pet euthanized?
No
Yes
If yes, please explain:
If you have pets, will they adjust to a new pet in the house?
Yes
No
Unsure
N/A
Please describe in detail the pet you are looking for.
Do you own or rent your home?
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Own
Rent
Someone else owns the Home
Someone else rents the Home
Please select your current residence type.
House
Apartment
Condo
Townhouse
Mobile Home
Other
If you rent, does your landlord and lease allow pets?
Yes
No
Unsure
N/A
Including yourself, how many people live in your household?
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Please list the ages & relationship of those who live in your home.
On average, how many hours per day will your pet be left alone?
Will this pet be predominantly living inside, outside, or both?
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Inside
Outside
Both
Please provide a description of this pet's living conditions.
Do you have a completely fenced-in yard?
No
Yes
If you do not have a fenced yard, how will you let the animal out?
Where will the animal sleep?
In bed with me
In bed with my child
In a dog / cat bed
In a kennel / crate
Wherever he or she likes
Outside
Other
If you answered "other" above, please explain:
Have you ever been convicted of abuse or neglect of a child or animal?
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No
Yes
If yes, please explain:
What will you do with the animal when you go on vacation?
Leave with family/friend
Boarding
Pet sitter
Take with me/us
Other
If you answered "other" above, please explain:
For what reason(s) would you consider returning/giving up the animal?
Are you willing to take responsibility for this animal for the next 10-20 years?
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No
Yes
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.
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Clear
